Internet‐Based Treatment for Panic Disorder: Does Frequency of Therapist Contact Make a Difference?

Abstract

Internet‐based interventions with therapist support have proven effective for treating a range of mental health conditions. This study examined whether frequency of therapist contact affected treatment outcomes. Fifty‐seven people with panic disorder (including 32 with agoraphobia) were randomly allocated to an 8‐week Internet‐based cognitive behavioural treatment intervention (Panic Online) with either frequent (three e‐mails per week) or infrequent (one e‐mail per week) support from a psychologist. Posttreatment, intention‐to‐treat analyses revealed that both treatments were effective at improving panic disorder and agoraphobia severity ratings, panic‐related cognitions, negative affect, and psychological and physical quality of life domains, with no differences between conditions. High end‐state functioning was achieved by 28.6% of the frequent and infrequent participants, respectively. Therapist alliance, treatment credibility, and satisfaction also did not differ between groups, despite significantly greater therapist time invested in the frequent contact condition. The results provide evidence that the effectiveness of Internet‐based mental health interventions may be independent of the frequency of therapist support and may, therefore, be more cost‐effective than previously reported.

Keywords:

• Internet intervention
• panic disorder
• therapist‐assisted
• CBT treatment
• randomised controlled trial (RCT).

Acknowledgments

The authors acknowledge the contribution to this research by the late Professor Jeffrey Richards and Dr. Marlies Alvarenga. In addition, we thank all those who have contributed to the development and modifications of the PO program over the previous 10 years: the late Professor Jeff Richards, Mr. Alan Penhall, Dr. Marlies Alvarenga, Ms. Gwenda Cannard, Mr. Anthony Archbold, Mr. Joe Bolza, Dr. Marica Pope, Mr. Mal Boyle, and Ms. Katy Symons. Funding for the original development of the PO program was granted to the late Professor Jeffrey Richards by the Australian Rotary Health Research Fund and subsequent funding was received from the National Health and Medical Research Council and beyondblue Victorian Centre of Excellence.